A 30-year-old falls on an outstretched hand. X-ray shows a fracture of the proximal one-third of the ulna with anterior dislocation of the radial head. The diagnosis is:

• A Monteggia fracture-dislocation ✓
• B Galeazzi fracture-dislocation
• C Essex-Lopresti injury
• D Colles' fracture with associated radial head subluxation

Explanation

Monteggia fracture-dislocation is defined by a fracture of the proximal third of the ulna associated with dislocation of the radial head. The Bado classification describes the direction of radial head dislocation: Type I (anterior, most common) accounts for approximately 60% of cases. Galeazzi fracture involves the distal third of the radius with distal radio-ulnar joint disruption. Essex-Lopresti is a radial head fracture with interosseous membrane disruption and DRUJ dislocation. Monteggia in children can be treated with closed reduction; adults require ORIF of the ulna and radial head reduction.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.